Factors associated with adherence to antiretroviral therapy in HIV/AIDS patients: a cross-sectional study in Southern Brazil

Abstract

A cross-sectional study was conducted on HIV-infected adults being treated with antiretroviral drugs at a reference service in Southern Brazil. Participants answered a sociodemographic questionnaire and were tested by scales assessing sociocognitive variables. Adherence to treatment was assessed by a self-report inventory developed for the study. Clinical information was obtained from the patients' records. Significance tests were conducted using univariate logistic regressions followed by multivariate logistic regression analysis. A total of 195 patients participated in the study and 56.9% of them reported > or = 95% adherence on the previous two days. In univariate analysis, the odds of adherence increased with self-efficacy (a person's conviction that he/she can successfully execute the behavior required to produce a certain desired outcome) in taking medications as prescribed (OR = 3.50, 95% CI 1.90-6.55), and decreased with perception of negative affect and physical concerns (OR = 0.71, 95% CI 0.53-0.95). The odds were lower for taking antiretroviral medications >4 times a day (OR = 0.44, 95% CI 0.20-0.94) and higher for patients with 8 years of schooling (OR = 2.28, 95% CI 1.12-4.66). In the multivariate analysis, self-efficacy (OR = 3.33, 95% CI 1.69-6.56) and taking medication >4 times a day (OR = 0.34, 95% CI 0.14-0.80) were independently associated with adherence. Self-efficacy was the most important predictor of adherence, followed by number of times antiretroviral medication was taken per day. Among sociodemographic and clinical variables, only the number of years of schooling was associated with adherence. Motivational interventions based on self-efficacy may be useful for increasing treatment adherence.

Adherence to Anti-Retroviral Therapy among People Living with HIV and AIDS in Far West, Nepal

“…Similar to other studies elsewhere 17,[20][21][22] age, sex, marital status, education level and employment status were not affecting adherence to treatment. However higher education status was reported to be better adherence to treatment.…”

“…However higher education status was reported to be better adherence to treatment. 22 Patients from the hilly area had poor adherence than that of client from Terai region, probably due to transport and time costs. This suggests that patients would benefit if ART services were available in more institutions located closer to beneficiaries' homes.…”

Associação entre uso de álcool em indivíduos com AIDS e adesão ao tratamento antirretroviral: uma revisão da literatura

“…A não adesão aos novos medicamentos antirretrovirais pode ser considerada uma ameaça tanto à efetividade do tratamento como para a disseminação de vírus-resistên-cia. Portanto, identificar os fatores que limitam a adesão é de grande relevância para que medidas que melhorem a adesão possam ser implementadas pela equipe de saúde [4][5][6] .…”

Pessoas vivendo com HIV/AIDS: variáveis associadas à adesão ao tratamento anti-retroviral

“…Nessa concepção teórica, o indivíduo é visto como capaz de lidar ou manejar as circunstâncias que eventualmente o impeçam de realizar comportamentos de saúde, tanto preventivos quanto de tratamento. Em estudos com amostras de pessoas vivendo com HIV/AIDS, escores mais elevados em expectativa de autoeficácia estiveram associados à melhor adesão à TARV 12,13 .…”

“…A associação entre variáveis sócio-demográ-ficas − gênero, idade, etnia, escolaridade e renda − e adesão à TARV tem sido pesquisada com resultados controversos 15. Estudo com pessoas HIV+ brasileiras constatou que, entre variáveis sócio-demográficas e clínicas, apenas escolaridade apresentou associação significativa com adesão, sendo esta mais satisfatória entre pessoas com mais anos de estudo 13 .…”